5 Ways to Improve Access to Sanitation

PSI representatives from Haiti, India and Washington, DC traveled to the UNC Water and Health Conference to present on its water and sanitation experiences and learn from other researchers and professionals.

Much of the conference focused on what it will take to achieve Sustainable Development Goal 6: access to safe water and sanitation. Although the international development community has made significant progress on sanitation, there are still gaps to fill when it comes to research, gender inclusivity, market development, rural sanitation and involving the private sector. Here’s what PSI learned at the conference:


  1. Safely managed sanitation is the “elephant in the room” and is going to take a new way of working to make significant progress.

The Sustainable Development Goal baselines show progress in coverage of basic sanitation, which is a hygienic toilet at home. However, the road that takes us from basic to safely managed sanitation, when all sanitation is also safely treated and disposed or reused, faces three roadblocks.

  • First is the understanding of the problem of unsafe sanitation management and its associated consequences. The knowledge and data gaps around what is currently unsafe are glaring, with only about a quarter of countries having data.
  • Second, the scale and complexities of sanitation mandate active collaboration with the government to bring in the necessary supporting policies and guidelines. Safely managed sanitation requires active government buy-in and regulation.
  • Finally, the magnitude of this challenge – the scale of the problem, substantial investment requirement and behavior change of market actors across the sanitation value chain – requires a business “unusual” approach. This was a notable theme of the entire conference. Some of the elements of a new way of problem solving may include innovative models for funding and financing, as well as active collaboration across players. Collaboration across development partners, donors, consumers, the private sector, national and subnational governments could produce effective and efficient ways of accelerating progress towards safely managed sanitation.


  1. WASH and gender issues are coming to the forefront, but there are many gaps in research, evidence and actual practice.

Gender-sensitive WASH programming has primarily described women as a vulnerable population that is disproportionately affected by poor WASH conditions. Going forward, in order to achieve the Sustainable Development Goals, WASH programs need to involve women as valuable change agents capable of influencing their communities. However, we must avoid assuming that women would prefer to work in certain roles and, instead, take into account the aspirations and preferences of individual women in each context and create opportunities that they desire. As a sector, we lack data on the impact of gender-inclusive programming, including the impact on market growth, community behaviors, business profits, women’s sense of empowerment, and domestic responsibilities. Programs should commit to collecting and sharing this data and evidence so that we can strengthen the role of women as change agents in achieving universal access to basic sanitation.


  1. Household water treatment (HWT) needs a more systematic approach to reach more market segments and be available for all consumers that need and want to use it. The HWT network must adapt to these realities.

Working to achieve safe water and sanitation presents new opportunities for the HWT network members to shift from a humanitarian-focused response to a development-oriented intervention. The focus within Sustainable Development Goal 6 on water quality is an exciting development. The sustainable development target for safely managed drinking water for all underscores the need for a systemic market-based approach to household water treatment. The HWT technology market is diverse, and not all technologies are effective in improving water quality or are accepted by users.


  1. Practitioners in rural sanitation are joining approaches to find ways of achieving the Sustainable Development Goal for ending open defecation

Responding to recent research and a growing evidence base around what is working and not working in rural sanitation, a community of practitioners is committing to joining approaches and seeking opportunities to collectively chart a new way forward to accelerate progress on achieving the Sustainable Development Goal for ending open defecation. This will include, among other strategies, a specific focus on improving sanitation products and services for the poor and disenfranchised. It is hoped that this collaboration will address the current limitations in programming, especially about quality and targeting. Second, collective action should take the focus away from what organizations do individually and focus on fixing the wider set of issues keeping things from happening sustainably and at scale (contribution vs. attribution). Lastly, these approaches put achieving and monitoring collective results at a premium and will establish new monitoring tools for doing that.


  1. The private sector is engaged in WASH, but with limited examples. Most do not manufacture locally and do not have a presence in local markets.

Despite being recognized as a critical partner in achieving Sustainable Development Goal 6, it was noticeable how absent the private sector was at the conference. There were limited presentations and side events convened by the private sector; this includes both local and multinational players. Of course, there is a growing involvement by private sector players, social enterprises, local businesses, and multinational companies, supporting progress on the Sustainable Development Goals. But the scale of the problem requires a new level of engagement. It requires new programmatic approaches to bring local businesses into the market, new research on what the private sector is doing and on market opportunities, and targeted efforts to raise attention to the important role of sanitation.

Banner photo: © Population Services International / Banner Photo by: Manprit Shergill